J. Bunster1, M.V. Mauri-Stecca1,2, J. Leppe1, E. Nelson3, B. Heiderscheit4, M. Besomi1
1Universidad del Desarrollo, Clínica Alemana, Physical Therapy, Santiago, Chile, 2Advanced Physical Therapy, Physical Therapy, Anchorage, Alaska, United States, 3University of Wisconsin-Madison, Department of Family Medicine and Community Health, Madison, Wisconsin, United States, 4University of Wisconsin-Madison, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Madison, Wisconsin, United States
Background: Running-related injuries (RRI) are highly prevalent, and during recovery, runners monitor physical symptoms while gradually returning to pre-injury performance. The University of Wisconsin Running Injury and Recovery Index (UWRI) is a valid and reliable, 9-item, evaluative patient-reported outcome measure that is specific to running. The UWRI is responsive to changes in running ability following an RRI, and is appropriate for monitoring running rehabilitation in clinical and research settings. However, the UWRI is only available in English.
Purpose: To cross-culturally adapt and evaluate the psychometric properties of the UWRI Spanish version (UWRI-S) in Chilean runners, who are undergoing physiotherapy as a result of an RRI.
Methods: This study was conducted during two stages. First, the UWRI was translated and cross-culturally adapted to Spanish through a double forward and backward translation process, an expert committee review, and a pre-test using cognitive interviews. Second, the psychometric properties of the UWRI-S were assessed. During this stage, runners with different RRIs completed the UWRI-S, Lower Extremity Functional Scale (LEFS), Patient Specific Functional Scale (PSFS), Global Rating of Change scale (GROC), and Numeric Pain Rating Scale (NPRS) at baseline and follow-up. The number of weeks in physiotherapy and number of physiotherapy sessions were recorded. The UWRI-S was also completed 48 to 72 hours after the baseline assessment to determine the test-retest reliability using the intraclass correlation coefficient (ICC2,1). Construct validity was analyzed using Spearman correlations between UWRI-S and LEFS, PSFS, NPRS, GROC, number of physiotherapy weeks, and sessions. Internal consistency was evaluated using Cronbach's alpha (α), and the standard error of measurement (SEM) was calculated.
Results: For stage one, 31 runners participated during the pre-test, and suggestions were incorporated according to the cognitive interviews. Changes included the addition of “considering the last 7 days” to all questions, and the modification of item 9 from “How does your injury affect your confidence to increase the duration or intensity of your running?” to “How confident are you today to increase the duration or intensity of your running sessions as a result of your injury?”. For stage two, 43 runners were included (63% males, median age 34 [IQR 28-38] years). The median (IQR) of the scores were 14(9-21) for UWRI, 62(53-71) for LEFS, 4(3-6) for PSFS, 3(1-4) for NPRS, and 5(3-6) for GROC. UWRI-S demonstrated moderate positive correlations with LEFS (r=0.65; p<0.05), fair positive with GROC (r=0.45, p<0.05), fair negative with NPRS (r=-0.3; p=0.075) and no association with PSFS (r=0.25; p=0.1). UWRI-S demonstrated good test-retest reliability (ICC=0.87; [95% CI; 0.73-0.93]), with a SEM=1.6, and acceptable internal consistency α=0.94 for factor 1 (item 6-8) and α=0.75 for factor 2 (item 1-5, 9). No correlation was found between the number of physiotherapy sessions and the initial week of treatment with URWI-S (r=0.21; P=0.6).
Conclusion(s): UWRI-S demonstrated validity, reliability, and responsiveness to changes in patient-reported functional recovery in Chilean runners with RRI. The psychometric properties of the UWRI-S are consistent with the original, English version.
Implications: UWRI-S may be used to evaluate and monitor perceived running ability after an RRI in Spanish-speaking adults.
Funding, acknowledgements: The authors declare that they have no conflicts of interest with any financial institution or commercial organization.
Keywords: patient-reported outcome measures, psychometric properties, running-related injuries
Topic: Sport & sports injuries
Did this work require ethics approval? Yes
Institution: Universidad del Desarrollo, Clínica Alemana
Committee: Ethic cientific comitte of facultad de Medicina, Universidad del Desarrollo.
Ethics number: 2019-016
All authors, affiliations and abstracts have been published as submitted.
